Clinical audit of glaucoma patients admitted in khyber teaching hospital Peshawar June 2002 May 2006

ABSTRACT

To determine the demographic pattern, types of glaucoma and to evaluate the different types of surgical procedures performed in terms of efficacy and safety. The medical records of admitted pts. for glaucoma during June 2002 to May 2005 [4 years] were studied in detail to see type of glaucoma; Management and their outcome. The main objective was intraocular pressure at the time of admission and discharge. Demographic pattern and therapeutic efficacy was determined. Out of 16425 patients hospitalized for various eye diseases, 775 [4.7%] patients with 1042 eyes suffered from various types of glaucoma 542 [69.93%] of patients were having primary glaucoma while 256 [31.07%] eyes were secondary types. Primary glaucoma is classified as primary angle closure glaucoma 38.5% primary open glaucoma 27.35%, congenital glaucoma 7.6% and absolute glaucoma 1.82%. Among secondary type, traumatic glaucoma was 6.42% lens induced glaucoma 5.37% steroid induced 4.35% neovascular glaucoma 3.45% pseudoexfoliatry type 2.5% and uveitic 2.01%. The numbers of male patients were more than female. The mean age at the time of admission was 42.6 years.Trabeculectomy was the main surgical operation [76.83%] Other surgical interventions were paracentasis with peripheral iridectomy, cyslocryopexy, lens extraction and pupulloplasty. Trabeculectomy was the most successful surgery in 84.41% for primary type of glaucoma. For secondary glaucoma paracentasis for hyphema related glaucoma, cyclorcyopexy, with or without cataract extraction for steroid induced glaucoma. Main post operative complications were shallow anterior chamber 12.65%, hyphema 10.27%, and uveitis 5.6%. Primary glaucoma is the leading cause of hospitalization followed by secondary glaucoma Trabeculectomy with or without antifibrotic agent is still the operation of choice and successful in 90% of cases. For secondary glaucoma, cause is treated and the various surgical offered are successful in 95% of cases